Rajesh Kumar, ICAS National Consultant (Finance) Financial Management Group

1. FINANCIAL GUIDELINES AND FRAMEWORK FOR DELEGATION OF ADMINISTRATIVE AND FINANCIAL POWERS Rajesh Kumar, ICAS National Consultant (Finance) Financial Management Group Ministry of Health & Family Welfare Government of India

2. Why delegate? • A highly decentralized initiative with real theatre of action situated at the grassroots level cannot be implemented with centralized power structure. • Flexibility under the Mission also means flexibility in decision making based on local needs.

3. Expanding allocations

4. The absorption capacities within the system needs to increase in consonance with the quantum jump in fund allocation. • We are not able to absorb present level of funds. • Faster decisions will mean faster implementation  greater absorption of funds.

5. EXPENDITURE OF EC-SIP ORISSA 70000000 6,19,93,329 60000000 50000000 40000000 EXPENDITURE 30000000 20000000 1,57,69,016 1,28,59,895 77,92,936 10000000 1,00,000 35,030 0 99-2000 2000-01 2001-02 2002-03 2003-04 2004-05 YEAR Trend of expenditure before and after Delegation in Orissa under EC-SIP

6. Fund flow cycle

7. Governing Principle-1: • All the departments having a role in the implementation of the State PIP should be represented in the State Health Society • approval of the State PIP by the Governing Body would be deemed to be the approval of the State Government • The same holds good for DHAP

8. Governing Principle-2 • Since a PIP is forwarded only after the approval of the State Health Society, the approval of the NPCC in the GOI on it may be deemed as Administrative Approval for that PIP • in case any activity was not included in the State PIP but was added to the PIP based on decisions arrived at in the meeting of the NPCC in the GOI, such activity should be taken up for implementation immediately.

9. Governing Principle-3 • The power to accord financial approvals/ sanctions should vest at the level where the funds have been devolved

10. Governing Principle-4: • Approving authority [the NPCC in the case of State PIP and the State Health Society in the case of DAP] should identify the core activities • The Executive Committee of the State / District Health Society should be authorised to enhance / reduce the allocation for the core activities by up to 10% of the approved allocation provided (a) the overall allocation for the approve plan remains the same and (b) the management costs do not exceed 6% of the total approved outlay.

11. Governing Principle-4(cond/..) • For the remaining activities, that is, the activities not identified as core activities, the Executive Committee of the State / District Health Society should be authorised to enhance / reduce the approved allocation provided that (a) the overall allocation for the approve plan remains the same, (b) the management costs do not exceed 6% of the total approved outlay.

12. Governing Principle-5 • The delegated powers for the office-bearers and authorities of the SHS and DHS should be same across all programmes and the framework of delegation of these powers should also apply to the State’s share contributed to the State Health Society under NRHM. • However, procurement procedures (including Civil Works) for any programme should be in accordance with specific agreements entered into with funding agencies or donors, as the case may be.

13. Delegation of Powers at SHS

26. Delegation of Powers at DHS

35. Rogi Kalyan Samiti (HMS)

39. Management of funds by BMOs and MO in-charge of CHC/PHC regular prog. funds under NRHM

40. Banking Arrangements

42. SOE submission

44. Management of funds at the Sub-Health Centre level

48. Management of funds by the Village Health & Sanitation Committee (VHSC)